Self Care Unit

For a long time, coffee shops were my de facto office for blogging, but I’ve found an even better place. It’s quiet, the lighting is fantastic, and even the smell is pleasant. Most importantly, there is just the right amount of people passing by that I can switch easily between focused attention and deliberate distraction. The nearest free parking is a block away, and I have to relocate every hour or two as the time limit is reached, but on balance, Royal Jubilee Hospital makes a great new office.

As we all know, I’ve logged some serious hours in hospitals in my time, the most recent due to adverse reactions to the chemotherapy I was on last year. I’ll be back here in two days for a fluoroscopy to see if anything can be done to ease the discomfort in my throat (there’s a stent holding my left vocal cord in the “ON” position. It helps me speak clearly, but also causes me to cough persistently to clear my throat). A couple weeks after that I’ll be back here for a CT scan of my left wrist which I injured 6 weeks ago (we suspect a fractured scaphoid, a tiny bone at the base of the thumb). Any treatment needed for that will likely mean additional visits here. The frequency of hospital visits shows no sign of slowing and that’s just fine by me.


Rox and I recently cancelled Netflix and subscribed to Crave+HBO. Watching TV is a very effective brain break, perfect for when I’m too cognitively fatigued to do anything, but not tired enough or ready to go to bed. I’m not one to really get into actual TV shows and typically spend more time watching YouTube channels of painters, woodworkers, and other creatives. That said, I am fully hooked on The Good Doctor, a medical drama centred on Dr. Shaun Murphy (played to perfection by Freddie Highmore), an autistic surgical resident with savant syndrome at San Jose St. Bonaventure Hospital. I finished binge-watching both seasons currently available yesterday so I just started over again; medical jargon has become my second language.

This show has shed light on some of what happened to me in  Vancouver General Hospital all those years ago. Watching a patient at St. Bonaventure go into cardiac arrest and a doctor massaging the heart during surgery, I get to see what my body has gone through. When the doctors have to make split-second, life and death decisions on a patient coming to the ER with multiple traumasI get a sense of the urgency with which I was attended to. I see surgeons fighting to save a kidney before removing it in order to save the patient and realize the same decisions were made when I was on the operating table


As I’m writing here, I realize I need some clarification and approach a table next to me where four people in scrubs are sitting, “Sorry to interrupt, but can I ask a general surgical question?”

“Sure,” answers the oldest guy, Mike, who I learn is an instructor at the hospital.

“Which type of cardiac arrest requires manually massaging the heart, and is that scenario what’s referred to as ‘flatlining”?” My quick internet research is making me sound more educated than I am, but then again, my experience is an education of sorts.

“Well, that type of therapy is used when regular CPR techniques aren’t an option, like during surgery or if the ribs are fractured. It’s an emergency last resort.”

“So if that doesn’t work, there’s nothing to try after that.”

“Right. Why do you ask? Are you a med student?”

“No, that happened to me.”

As expected, jaws drop, and the conversation turns to a brief history of what I’ve survived. The group expresses amazement, first that the heart massage was a success, then again when I tell them I had my left kidney and spleen removed. Just as they’re getting over that, I hit them with the whole torn aorta thing and they’re levelled once more. As they slowly begin to regain composure I’m asked what caused the head injury. I tell them it was a car accident and that my C-1 vertebrae was fractured. Now I’ve really made their day. Mike, the instructor, suggests different avenues for me to share my story, either at high-schools or even with med school classes. I respond that the cognitive workload makes it cost prohibitive, but I wonder if the rewards could be greater than I anticipate.

After enjoying this bit of celebrity and once the group has left, I sit and wonder what the ER looked and sounded like when I was on the table. From my conversation with Mike, I now know that I went into an asystole cardiac arrest, and did indeed flatline for three minutes.  I find this image of a left-sided thoracotomy (the surgery performed to gain access and repair my aorta, among other things) and just stare at it, imagining the high-pitched tone of the ECG, constant for three minutes.

It’s intense.


I’ve been feeling detached lately – unsettled, slightly anxious, and getting a little depressed because of it. I had this sense that I’d forgotten something important, and that I needed to pay attention to something somewhere. I feel that writing here at the hospital has helped, and I’m starting to understand why I like spending time here. In the hospital, whether it’s the MSA Hospital in Abbotsford, Vancouver General, Victoria General, Saanich Peninsula, or Royal Jubilee here in Victoria (all of which I’ve spent time at), there is a higher concentration of people who more fully appreciate what I’ve been through and the implications of it. I don’t feel as misunderstood here, and it’s comforting. Most people here are either going through something life-altering or treating someone who is. Some, like the group of scrubs I spoke with earlier, appreciate what an asystole cardiac arrest is to an extent I’m only beginning to grasp. Just now, I asked a couple women one table over if the correct phrasing is “asystolic cardiac arrest” or “an asystole cardiac arrest,” and one of them, a cardiac nurse, informed me it’s the latter. Interactions like that are why I set up here in the Diagnostic & Treatment Centre instead of the more casual Patient Care Centre atrium next door.  The hospital feels like my home away from home. The people here are my people, and spending time here is spending time with a part of myself that gets buried in the day-to-day hustle. 


It’s 1:18pm now and I’ve been here since 7:00am. I’ve moved my truck three times and have 6 minutes before I need to move it again. I took this week off work to address this drifting feeling and I’m proud of myself for listening to my body/brain and deliberately working to process what I’d been experiencing. I think I have enough time to grab some Timbits downstairs, maybe hit the Subway over in the Patient Care Centre, then catch an episode of The Good Doctor before picking Rox up from work. It’s been a good day.





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Spare Change?

So here we are again, creeping up on the 16th anniversary of my car accident, my acciversary. I’m writing this in the cafe at Vancouver General Hospital, my home for two months back in 2003. Various staff members dressed in scrubs are scattered around the lounge, one tries to nap with her hoodie on backwards to block the light. I haven’t wandered around the Intensive Care Unit or the Trauma Special Care Unit today, but just being at the hospital feels like tribute enough, and it is especially conducive to writing a blog post.

Yesterday I was having coffee with Jon, my good friend and former boss at the Cyclery. He sustained a significant head injury in a bicycle crash five years ago. When we aren’t laughing about puns and bike shop stories, or geeking out over woodwork and the latest gadgets from Makita and Festool, we swap thoughts and lifehacks for living with brain damage.

I have an 11-year headstart (headinjurystart?) on Jon in terms of living post traumatic brain injury and in our conversation Jon asked “So, what changes?” I took a moment then told him the anxiety decreases. I used to be crippled with anxiety, especially in social settings and large groups of people (note: large = 3 people). Anticipatory anxiety ruled the lead up to any interaction, social anxiety levelled me during it, and ruminating  fuelled my anxiety afterwards. Anxiety was my closest and worst friend.

Today, as I told John, I haven’t had that level of anxiety in years. I’ve recovered from that particular aspect of injury and I’m generally pretty relaxed, just like I was pre-accident.

But I’m not like that at all.

True, I don’t get stressed out and anxious like I used to 16 years ago, or even 10 years ago, but that has nothing to do with recovery or some trait that I’ve returned to. It’s only because I’ve arranged my life in such a way that avoids the stress triggers I was, and continue to be, sensitive to.  The thing is, it happened so gradually that I didn’t even notice. I look at myself and think, “Ah, I’m just not a people person…” and “I just really enjoy watching movies instead of doing stuff with people…” and “I would rather just chill out at home instead of going out, that’s just the way I am. I’m a mellow dude.” These statements are true, but they don’t describe innocuous, natural developments. The developments are a response, a reaction to an originating action: the car accident. Avoiding stress and anxiety was the first and only thing I thought of early on, and it wasn’t until Jon asked that I realized it still is. Whether it’s social anxiety, physical stress related to my spinal issues, or cognitive deficits at work, I instinctively arrange things the way I need them to suit me best.

For example, the whiplash that fractured my C-1 vertebrae also tore most of the ligaments on the left side of my neck. This one fact, alone, has caused a ripple of necessary interventions. I sleep on my back with my head tilted slightly to the left to engage the ligaments on the right side of my neck. If I were to fall asleep with my head to the right, it would settle in at too much of an angle (as if I were looking over my shoulder all night) and I would likely need a chiropractic adjustment. I can lay on my left side for a little while, my right side even less, and never on my stomach. Back when I was at school and even now at the movies, I take seats on the right half of the room so that I’m always turned slightly to my left to see the action up front.

I carry earplugs with me now. I put them in at coffee shops if it’s too crowded, at my sister’s place when the kids are vying for attention, at work when my boss’s dog shows up. It’s automatic and makes things less stressful. To me, it’s not weird anymore, it’s just necessary. These accommodations, and countless others, have become habit over the years, so much so that I forgot they were accommodations in the first place.

So what changes? The newness of everything changes. The challenges and deficits I encountered have become old news, the adjustments I’ve made in response to them, slightly less old. I see the effects of the car accident everywhere and nowhere at the same time, I’m just that used to it.

That’s what changes, Jon, you get used to it. All of it.


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Unluckiest Guy Alive.

This month marks 15 years since the car accident, and it feels like a suitable time to revisit this blog with an update. I’m on the ferry heading to Vancouver from Victoria where Rox and I have been living for a couple years. The ferry is strangely empty and it’s almost spooky how quiet it is. It’s mid-day but the ocean and the sky are different shades of the same grey. I wonder if we inadvertently boarded a ghost ship, and if so, I hope the usual boarding announcements will be made by Captain Jack Sparrow, or at least someone who sounds like him.

It’s something of a loosely held tradition to go see my old stomping grounds each year to chat with the folks working in the Vancouver General Hospital Intensive Care and Trauma Special Care Units. Recently I’ve started bringing my car accident/hospital stay photo album to help them connect the dots of who I am now and which guy I was then. This year I’m also equipped with six dozen black Sonix Gel pens, the clicky kind, you know, because pen lids are a hassle and tend to go missing.  In the ICU, good pens are cash money and today I’m making it rain.

Hospitals, to me, are like Club Med, an all-inclusive facility where everyday worries fade away, the  room service is impeccable, and all you do is lay around and joke with the staff.  My uncommon affinity for medical care facilities was reaffirmed three weeks ago at the Royal Jubilee Hospital in Victoria. I was scheduled to have a malignant melanoma removed and a subsequent skin graft to close things up again. Melanomas are a type of cancer, and mine had been growing for five years. When the initial biopsy results returned positive for a superficial spreading melanoma, my first response was, “Really? That’s what we’re doing now? Of all the dumb luck…” My mind started tallying up the challenges I’ve had to endure, hitting me with the highlights: brain-damage, divorce, cancer. Life was constant maintenance work before cancer, and now I have to deal with that too?

Sometimes the fifteen years since the car accident feels like a fifteen-year streak of bad luck. It’s as if the car-accident released the floodwaters of stress, trauma, and pain into the canyon of my life. What was an adventurous journey on a steady current became a fight for survival down treacherous rapids. And sometimes I wish it would just let up, you know? Brain-damage, divorce, AND cancer? Enough, already.

The other day, as I was mulling over this latest tough break, a totally contradictory thought flashed in my mind – what if I’m actually one incredibly lucky sonofabitch? Well, ok, I thought, let’s see where this goes.

Okay, the first one, the car accident, is an easy one. The doctor’s gave me a 1 in 10 chance of survival, remember? There was a ninety percent chance I would die – ninety percent!! If I were a betting man, I’d go with the ninety percent odds, take my money, and run. But I’m not a betting man, I’m a lucky man, and beating the odds of survival is just the beginning.

The complexities of the brain mean a staggering variety of impairments can occur when the brain is injured. The damage to my brain was a severe amount, first from the impact of the truck hitting my side of the car, and later from my brain’s oxygen supply being cut off through three minutes of cardiac arrest. Yet my level of functioning baffled doctors early on and continues to today. I’ve become increasingly efficient at working around the biggest obstacles and even overcoming others. That kind of trajectory in recovery doesn’t happen everyday, but it happened to me.

Next, divorces are painful and difficult to go through, that’s a given, yet it doesn’t take much to see that mine was handled pretty well. Despite the inevitable challenges that arise in divorce, I know that care was taken to ensure that I was not unnecessarily burdened. We don’t chat or email often, but when we do there is still care and compassion. Some say amicable divorces are a myth, but my luck is mythical too.

Finally, of the four types of melanoma, superficial spreading melanoma is the most common and least invasive. In that sense, it’s not surprising that despite growing for five years, the tumour hadn’t appeared to have invaded my lymphatic system (even so, the sentinel node, the one closest to the melanoma, was removed along with the next two as a precaution). What is lucky about this whole experience is that, because of the pre-op paper work and post-op follow-ups, I needed a family doctor. The walk-in clinic doctor I usually see asked a colleague and she agreed to be my doctor. Do you know how hard it is to get a family doctor in Victoria right now? The odds aren’t great, I’ll tell you that.

In sum, I survive a car accident when I should have been written off along with my car, my brain is rewriting the textbooks (or at least this blog) on what brain damage means, the long-term effects of my divorce are negligible, I get the good kind of melanoma, and no longer have to wait at walk-in clinics.

Try finding someone who catches those kind of breaks. Good Luck.




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Epilogue: From Happy Ending to Fresh Start

I was surprised when I realized this, so it’s understandable that some of you will be as well, but this is the the end of TheBrainDamageDiaries.

In response to a challenge laid out by a fellow literary/creative acquaintance, I set out on February 14, 2011, to blog weekly for a year. The idea was that out of fifty-two blog posts, there should be at least one good one, something that could pass as an example of good work. This is my seventy-third post so it stands to reason that there should be one-and-a-half good posts in here somewhere.

Flipping through TheBrainDamageDiaries, like any diary, is a surreal yet comforting exercise. When I started, I had no idea what to record, and how to best present it (bold type was a good call, right?). Writing, at the time, was extremely labour-intensive, and I would set aside whole days for crafting a single blog. Eventually, as the therapeutic value of writing emerged, blogging became something I looked forward to each week. In addition, I’m convinced that maintaining this blog has shaped my brain in beneficial ways, activating and strengthening neural pathways that would never have been otherwise.

TheBrainDamageDiaries has been many things: a self-help book, an owner’s manual, a mirror, a display case to share my victories, a discussion board for my observations, and most of all, an environment for growth. That growth has brought me to a point now where continued intense self-analysis isn’t necessary, and may instead be counter-productive, so I’m going to quit while I’m ahead. I’m in a good place now, at the intersection between the ending of one stage of life, and the start of another. This blog captures the stage I’ve just concluded, and I don’t intend to capture the next one in written form, at least not to the extent that I have for the past 73 weeks.

In my first post, I declared this blog to be a shift from Reverse to Drive, from surviving to thriving. In that sense, this blog always had a pending expiry date. Starting this blog initiated that shift, and ending this blog is completing that shift. On the one hand, it feels strange to conclude my blog here, especially since I didn’t expect to. On the other hand, it frees up the time, energy, and most importantly, the headspace to be myself to the fullest extent – at once entirely different from who I was, yet exactly the same person.

It would be very remiss of me not to acknowledge the support and encouragement I’ve received from everyone who has read my blog. Thank you for reading my ramblings and making my inaugural blogging experience a fruitful one.

Okay, time to go – I’ve got things to do!

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Organic & Free Range

I know, I’m four days late with this post or, as those glass-half-full folk might say, I’m three days early. Either way, I sat down the other day, when I was only a day late or so, with what I thought was an interesting observation, and it wasn’t until I was about four paragraphs into it that I realized it was rubbish. My motivation signalled defeat as my mental outline deflated slowly before finally collapsing in on itself, creating a vacuum that threatened to take the rest of my brain with it. Interestingly, this happens most often when I approach my blog with a premeditated idea of what to write. In most other applications, foresight and anticipation are rewarded with a speedy, efficient performance and better results. For whatever reason, when it comes to blogging, I do my best when I take a second to listen to myself, and then just start typing.

So here we go.

A lot has been going on the past week, hence the late/early post. I’ve been doing full days at the shop regularly for some time now, and though I enjoy my time at work, things on the home front seem to fall slightly by the wayside – items that need to be mailed out sit on my dining table still; that pile of clean clothes in the corner of my room continues to migrate from the floor to my bed, where it waits to be folded and put away, only to be demoted back to the floor each evening; and though the overall level of tidiness is tolerable, it’s not quite where I’d like it to be. There are many things that could be done, but I’ve been quite happy to give myself the evening off – for the past two weeks.

Amidst all the business and busyness, there has also been a lot of action going on between my ears, or, as I jokingly told a customer who asked where the noise on her bike was coming from, just below the helmet. Until very recently, I’ve been hyper-aware of every thought pattern regarding the events of this past year. I’ve reverse-engineered everything that has brought me to this point in a bid to look at each one objectively and honestly. Aware of my own tendencies and perhaps selfish motives, I’ve outlined strategies to process things in a healthy way, to move onward and upward in a trajectory laced heavily with logic and pragmatism. I’ve second-guessed my second guesses, raising the level of introspection exponentially, and any parts of my brain that aren’t damaged are most surely burnt out by now. I don’t do this because I like it, I just want to be healthy and whole again. But with this war waging in my head, I was shooting myself in the foot.

You see, the past couple of weeks have been so busy, that I was unable to take the time I usually reserve for reflection and self-analysis. Introspection is not the sole purpose of this downtime, but that is what my mind wanders to when I relax and give my brain a rest, and it seems like a good practice. With this part of my routine effectively removed, however, I was doing something that I haven’t done for a nearly a decade, something that I’ve been longing to do – I was just living. And just living is what I need to get back to.

The ability to just live is exactly that, an ability. When people have traumatic experiences, they lose that ability and it feels impossible to get back to just living. You can’t un-see the things you’ve seen, you can’t un-know the things you know, and you can’t forget the things you remember, no matter how badly you’d like to. We all need to continue living, of course, but how do we get back to living life? First, we need to recognize that the act of moving on does not invalidate or belittle the trauma we’ve faced. Then we need to decide how much of that experience we take with us in our day-to-day life. Some may take up a cause, a project that can reconcile their experiences with the world around them. Others may simply learn to compartmentalize, tending to the things that need tending, then shelving them until they require further attention. For myself, I need to be a little less involved in my recovery. I have to trust myself, that the person I am and the way I am can take it from here. It turns out that I need to get out of my way, because all the analyzing, plotting, and planning I was doing to ensure healthy and steady growth simply got in the way of something more valuable – authentic, organic, and wholesome recovery.

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The Avengers and Me

It was hot today. I went down to Fort Langley to hang out and relax, and there were so many people there milling about, checking out the shops, eating gelato, and enjoying the sun. I wasn’t out in the sun, however, I was sitting in the shade trying to read, but two whining dogs tied to a truck hitch nearby made that less than relaxing. Instead, I decided to sit out the hottest part of the day, and made my way to the movie theatre to watch The Avengers in 3D.


Generally, I’m not a fan of 3D movies. After a minute or two of the 3D sensation, the effect seems to wear off and everything falls back into 2D. It’s like my brain figures out what’s going on and decodes everything so that my eyes fail to create the illusion. It’s kind of a pity, really. Instead of a lasting 3D experience, I leave the theatre with bloodshot eyes. The only advantage of this particular 3D showing was that it was playing when I arrived at the theatre.

The Avengers gathers the heroes of it’s previous films (The Hulk, Thor, Ironman, Captain America and others) into what Roger Ebert calls, “the Westminster Dog Show of superheroes.” It is a spectacle, to be sure, but a well balanced one, playing to each character’s unique strengths and abilities. At this point of the Marvel saga, none of the heroes have secret identities anymore, but they still have alter egos. When they aren’t in their slim-fit uniforms and outfits, they are simply the people they are.

This is something I have been working through: who is Jay Brandsma? It’s not an easy question to answer, because I’m not fully convinced yet that I don’t have super powers. Powers or not, knowing who I am is the most elusive, yet vital piece to the life I’m putting together here. It would be nice if it were all laid out somewhere, like in a comic book – stories of how I started, what my powers and weaknesses are (every hero has a weakness), the demons from my past that haunt me (every hero has those too), and the values and personality that guide my actions and battles. If I could just get that info packaged up like that, maybe with some flashy pictures, I’d be set.

Instead, I have to gather this stuff together in real time – real slow time. This is a long, arduous, and delicate process, one that can easily be swayed by trauma, insecurity, and weakness. Fear, pain, and even honest intentions can alter my steps, shifting my aim so that instead of looking for who I am, I am looking to be liked. My philanthropic nature can quickly take the priority from helping myself along, to helping others along, and while every superhero is praised for this behaviour, it can prove damaging for us mere mortals who are piecing life together after trauma. Trust me – I’ve been there, done that, and burned out. Just as physical rehab was my sole focus in the first couple years post-accident, my emotional and psychological rehab must take top priority now. I must continue to discover who I am. Like the glowing Tesseract cube in the movie, a clear understanding of who I am will become an unlimited source of sustainable energy, the key to future growth and development.

So I keep working at it. The first page of my comic book is unwritten now, save for a few things I’ve scribbled in the top corner, a collection of assumed constants and continuations from earlier in life – sense of humour and wit, good at spelling and math, a palatable style and appearance, etc… The rest is up for grabs, and I pencil things in before scribing anything permanently. As the list grows, however, I see more of who I am and what I am about. I notice flashes of familiarity, glimpses where my nature acted naturally.

I recognize myself.

And I fly away.

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Working With Muted Results

Please respond to the following statements by choosing the answer that best reflects how you feel:

1) Strongly Disagree

2) Disagree

3) Somewhat Agree

4) Agree

5) Strongly Agree

This format seems to be the only way to assess psychological makeup because I was inundated with these types of questionnaires early on in my recovery. In order to understand what level I was functioning at, nothing could be taken for granted and a baseline had to be established. For this reason, I found the first questionnaire to be somewhat amusing, if not a little creepy, when faced with statements like these:

“Sometimes I feel like those around me are trying to steal my thoughts.”

“I know people are out to get me.”

“I spend a lot of time thinking of ways to kill myself.”

Rest assured I responded with 1) Strongly Disagree to all of the above. Aside from the occasional statement that seemed to come from way out in left field, these tests were useful for identifying issues and tracking changes. In addition to psychological and cognitive assessments, this style of testing was later used to help me find suitable employment.

I remember meeting with a specialist whose job it was to help me identify employment options that might mesh with my newly emerging cognitive status while providing some sense of fulfillment and success. After a bit of chit-chat, I was left alone to “respond to the following statements by choosing the answer that best reflected how I felt.” As you might expect, the statements here did not involve confessions to alien encounters or conspiracy theories. It was established that I was capable of work, now it was a matter of finding what kind. For that reason, I was responding to statements like:

I enjoy working with my hands.  3) Somewhat Agree

I prioritize easily and get tasks done quickly. 1) Strongly Disagree

I really enjoy delegating and organizing group tasks. 1) Strongly Disagree

Now, I really do enjoy working with my hands, but at the time of this particular assessment, I was in such a place that “enjoying” anything was a dramatic overstatement. Furthermore, I found the idea of working regularly so intimidating that every option was summarily ruled out. Amidst the host of Strongly Disagree’s and Disagree’s, an optimistic Somewhat Agree would stand alone. There may have been a couple Agree’s, but I know there were no Strongly Agree’s. A few weeks later, when I met with the specialist to discuss the results of the assessment, he explained my responses were so uniformly low that there was no conclusion. The fear, insecurity, ignorance, and apathy I was experiencing at the time had muted the results of the test. In the end, I had no leads and little motivation to find answers to the employment question.

History, as they say, is doomed to repeat itself, and though I have successfully gained fulfilling employment (with or without that assessment’s help) I find myself in a similar position. I alluded to this in an earlier post, saying the very idea of fun and enjoyment seems frivolous and self-indulgent. Thanks to feedback from that post, I’m warming up to the concept of doing something “just for me,” but choosing a pursuit presents a similar conundrum as that job skill assessment. The slurry of fear, insecurity, ignorance, and apathy continue to dampen motivation and, to a greater degree, initiation and execution. I can think of a few options, but when I gauge my excitement about any of them, the results are muted.

The initial school of thought here is that maybe I’m just a very apathetic dude now, that this development is just one more less-than-ideal repercussion of my brain damage. And if that’s the case, maybe I’ll never be excited about recreational pursuits, and would that be such a bad thing? Heck, I could quite easily and convincingly play this up as a positive thing – that I’m even keeled and super laid back. But then I remember two things: 1) Recreation and hobbies are not meaningless pursuits, rather they are valuable pieces in building a balanced life, and 2) In time, and entirely on my own, I found a job that is endlessly fulfilling and very, very enjoyable.

So what does that tell me? It tells me that, in time, when I’m ready and able and capable, I’ll find extracurricular activities that won’t seem like a chore to engage in, while providing a level of enjoyment and a fuller sense of balance to my life.

As I said, I’ve been considering this for some time and a few creative options have Strongly Agree written all over them, the foremost of which involves paint and canvas

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